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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009356
Report Date: 08/13/2021
Date Signed: 08/13/2021 12:08:46 PM

Document Has Been Signed on 08/13/2021 12:08 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:JARA FAMILY CHILD CAREFACILITY NUMBER:
198009356
ADMINISTRATOR:JARA, OLIVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 814-1810
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
08/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Olivia JaraTIME COMPLETED:
12:20 PM
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Licensing Program Analyst (LPA) Fabiola Vasquez contacted the facility via telephone due to COVID-19 and precautionary measures LPA conducted the screening procedures and received the clearance to go into facility at 09:30 LPA conducted an unannounced required 1 year inspection. LPA met with licensee, Olivia Jara who guided analyst on a tour of the facility. Present were 7 children two being infants and S1,S2,S3,S4. Licensee states that there are currently 16 children enrolled. Days and hours of operation are: Monday to Friday from 06:00 a.m. to 06:00 p.m. The Licensee is within the conditions, limitations, and capacity specified on the license. The children's roster was reviewed and is current.
Family members residing in the home are 3 adults (criminal record clearances on file) and 0 children. Licensee has a pet dog, that stays indoor and outdoor.

This is a two story home which consists of 5 bedrooms( 4 bedrooms upstairs, 1 bedroom downstairs) 3 bathrooms (2 bathrooms upstairs, 1 downstairs) , kitchen, dinning room, 2 living rooms, (FIREPLACE: located in the living room across the kitchen is inaccessible to children in care.), attached garage and backyard (fenced).

Areas accessible to children were inspected as follows: Living room across the kitchen, dining room, bathroom in the first floor, back yard and the garage that has been converted into a play area

Areas off limits include: Second level is inaccessible to children, LPA observed the stairs leading to the second level has a fence making it inaccessible to children.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE: DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: JARA FAMILY CHILD CARE
FACILITY NUMBER: 198009356
VISIT DATE: 08/13/2021
NARRATIVE
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Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. There were safe toys, play equipment and materials observed for children. Stairs are fenced. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible or in some areas of the home. Poisons are locked, as required. The licensee does understand that poison must be locked with a key or combination lock.

There are safe toys, play equipment and materials observed for children.
Licensee was informed that children can not eat or sleep in the garage. Per licensee the garage is only used for playing.
LPA observed and inspected sleeping equipment for infants. LPA observed a crib or play yard for each infant in care who is unable to climb out of the crib or play yard. All equipment meets the US Consumer Product Safety Commission safety standards. LPA observed that cribs and/or play yards are free from loose articles or objects hanging above or attached to the side of the crib. There are no objects hanging above or attached to the side of the crib. LPA observed that cribs and play yards do not hinder the entrance or exit to and from the space they are sleeping in. Mattresses were observed to be firm and covered with a fitted sheet that is appropriate to the mattress size. Each infant has their individual bedding and is washed weekly as required. Soiled bedding is replaced when wet or soiled and is placed in an area inaccessible to infants. Pacifiers were observed to not be attached to anything and are labeled. Bumper pads shall not be used. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months should be placed on their back for sleeping.

LIC 9227 (Individual Sleeping Plan) for infants up to 12 months was explained along with PIN 20-24-CCP was issued to the Licensee. Title 22 Regulation Section 102425(j) Infant Safe Sleep was discussed with the Licensee, including but not limited to documentation that shall be maintained.

During the visit LPA observed a swing , licensee removed the swing during the visit by putting it in the trash. (Corrected during the visit). Rooms that are off-limits need to be made inaccessible during operating hours. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility. Car seats shall only be used for transportation purposes and shall not be used for sleeping.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: JARA FAMILY CHILD CARE
FACILITY NUMBER: 198009356
VISIT DATE: 08/13/2021
NARRATIVE
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Per licensee, there are no weapons, firearms or bodies of water on the premises. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The valve on the required 2A 10BC fire extinguisher indicates fully charged serviced 06/04/21). Smoke detector and carbon monoxide detector in the garage and dining room were tested, and are in operable condition. The licensee has current Pediatric First Aid and CPR, which will expire 05/22/23.

Proof of immunization against influenza, pertussis, and measles for the Licensee and Assistants was readily available during today’s inspection. Licensee has also taken the Mandated Reporter Training.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SB792 (Immunization Requirements for Staff and Employees) was reviewed and discussed with the Licensee.

AB1207 Mandated Child Abuse Reporting – was reviewed and discussed, on or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers Licensee completed training on.

The following was discussed:
· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: JARA FAMILY CHILD CARE
FACILITY NUMBER: 198009356
VISIT DATE: 08/13/2021
NARRATIVE
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· The Licensee shall be present in the home and shall ensure that children are supervised at all times.
· Children shall not be left in park vehicles.
· The capacity specified on the license shall be the maximum number of children for whom care can be provided.
· Car seats shall only be used for transportation purposes and shall not be used for sleeping.
· All children in care have the right to receive safe, healthful, and comfortable accommodations, furnishings and equipment.
· When a child shows signs off illness, they will be separated from other children until the nature if the illness is determined.
· Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

LPA reviewed and issued the LIC 311 - Forms/Records to Keep in Your Family Child Care Home.
CHILDREN’S FORMS/RECORDS, FACILITY FORMS/RECORDS and INFORMATION TO BE POSTED, Disaster drills (08/03/21), posting requirements, children records requirements, mandated child abuse and injury/death reporting, and criminal record transfer requirements were discussed.

LPA provided a Safe Sleep Awareness Campaign (PIN) 19-02-CCP dated February 20, 2019 packet, Never Shake a Baby (Pub 271), A Child Care Providers Guide to Safe Sleep (SIDS) American Academy of Pediatrics and California Child Passenger Safety Law during today’s inspection. PIN 21-02-CCLD Updates to the implementations of guardian.

The licensee’s email address was obtained during this visit. The licensee was advised that email is public information.
LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov
At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.
Exit interview was conducted with Licensee. The Licensee was provided a copy of the report and their appeal rights (LIC 9058) their signature on this form acknowledges receipt of these forms.
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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4